56-character length restrictions, including 1. TITLE OF PROJECT AIDS INTERNATIONAL TRAINING AND RESEARCH PROGRAM 2. RESPONSE TO SPECIFIC REQUEST FOR APPLICATIONS OR PROGRAM ANNOUNCEMENT OR SOLICITATION [] NO [] YES (If "Yes," state number and title) Number: PA-03-018 Title:AIDS INTERNATIONAL TRAINING AND RESEARCH PROGRAM 3. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR New Investigator [] No [] Yes 3a. NAME (Last, first, middle) Johnson, Warren D. 3c. POSITION TITLE Professor of Medicine 3e. DEPARTMENT, SERVICE, LABORATORY, OF_ EQUIVALENT Medicine 3f. MAJOR SUBDIVISION Medical College 3g. TELEPHONE AND FAX (Area code, number and extension) TEL: 212-746-6320 FAX: 212-746-8675 4. HUMAN SUBJECTS 4a. Research Exempt [] No [] Yes RESEARCH If"Yes," Exemption No. [] No inde'_er- 4b. Human Subjects 4c. NIH-defined Phase III _-'_ Yes mznate Assurance No. Clinical Trial FWA00000093 [] NO [] Yes 6. DATES OF PROPOSED PERIOD OF 7. COSTS REQUESTED SUPPORT (month, day, year--MM/DD/YY) BUDGET PERIOD From Through 7a. Direct Costs ($) 10/01/03 09/30/08 $1,000,000 9. APPLICANT ORGANIZATION Name Weill Medical College of Cornell University Address 1300 York Avenue New York, NY 10021 Institutional Profile File Number (if known) 12. ADMINISTRATIVE OFFICIAL TO BE NOTIFIED IF AWARD IS MADE Name Randall H. Phillips Title Manager, Grant Accounting Address 100 Broadway, 8th Floor New York, NY 10005-1983 3b. DEGREE(S) M.D. 3d. MAILING ADDRESS (Street, city, state, zip code) Weill Medical College of Cornell University 1300 York Avenue, A-421 New York, NY 10021 E-MAIL ADDRESS: wdjohnso@med.cornell.edu 5. VERTEBRATE ANIMALS [] No [] Yes 5a. If "Yes," IACUC approval Date 5b. Animal welfare assurance no A3290 FOR INITIAL 8. COSTS REQUESTED FOR PROPOSED PERIOD OF SUPPORT Tel 212-680-7131 FAX 212-680-6704 E-Mail rhphilli@med.cornell.edu 14. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR ASSURANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. I agree to accept responsibility for the scientific conduct of the project and to provide the required progress reports if a grant is awarded as a result of this application. 15. APPLICANT ORGANIZATION CERTIFICATION AND ACCEPTANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge, and accept the obligation to comply with Public Health Services terms and conditions if a grant is awarded as a result of this application. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. PHS 398 (Rev. 05/01) Face 7b. Total Costs ($) 8a. Direct Costs ($) I 8b. Total Costs ($) 151,079,.331 $5,309,138 $6,058E252 10. TYPE OF ORGANIZATION Public: --* [] Federal [] State [] Local Private: ---, [] Private Nonprofit For-profit:---* [] General [] Small Business [] Woman-owned [] Socially and Economically Disadvantaged 11. ENTITY IDENTIFICATION NUMBER 1131623978A1 DUNS NO. (if available) 60217502 Congressional Distdct 14 13. OFFICIAL SIGNING FOR APPLICANT ORGANIZATION Name Barbara Pifel, JD, RN Title Sr. Director, Grants and Contracts Address Office of Research and Sponsored Programs Weill Medical College of Cornell University 1300 York Avenue, A-131 New York, NY 10021 Tel 212-746-6020 FAX212-746-6938 E-Mail blp2001 @med .cornell.edu DATE SIGNATURE OF PI/PD NAME_) tN 3a. (In ink. _er" signature nc "_cc_table.) 03/07/03 SIGNATURE OF OFFICI. L NAMED IN 13. DATE (in ink. "Per" signature not _cspt_ble.) Page [unreadable] Form Page 1